TY - JOUR
AB - Reactions 1939, p444 - 14 Jan 2023 Hyperammonaemia: case report A 74-year-old man developed hyperammonaemia during treatment with valproic acid for agitation. The man, who had schizoaffective disorder, bipolar type, chronic kidney disease stage III and COVID-19 associated cognitive sequelae, presented with behavioral dysregulation and psychosis due to acute psychiatric decompensation and agitation. At home, he was receiving treatment with valproic acid for agitation [route and initial dosage not stated], benzatropine [benztropine] and aripiprazole. He was hospitalised. Laboratory examination revealed a valproic acid level of 44 µg/mL. Valproic acid dose was increased to 1750mg once daily to manage agitation. Thereafter, he had an initial improvement. However, he developed lethargy with neuropsychiatric symptoms such as altered sensorium and inattention. On examination, valproic acid level was found to be 106 µg/mL. The man’s treatment with valproic acid was discontinued. Investigations revealed an ammonia level of 38 µmol/L, which later increased to 51 µmol/L, indicating hyperammonaemia [duration of treatment to reaction onset not stated]. It was suspected that he developed hyperammonaemia due to valproic acid [outcome not stated]. Soin A, et al. (91) Neuropsychiatric Sequelae of Hyperammonemia: Clinical Pearls for the CL Psychiatrist. Journal of the Academy of Consultation-Liaison Psychiatry 63 (Suppl. 
TI - Valproic acid
JF - Reactions Weekly
DO - 10.1007/s40278-023-31852-2
DA - 2023-01-01
UR - https://www.deepdyve.com/lp/springer-journals/valproic-acid-Tkl4xCJ3Mt
SP - 444
EP - 444
VL - 1939
IS - 1
DP - DeepDyve
ER -